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Press releases Saturday 7 January 2006

Please remember to credit the BMJ as source when publicising an article and to tell your readers that they can read its full text on the journal's web site (http://bmj.com).

Viral infection at birth linked to cerebral palsy

Questions over ±healing effect± of magnets

Predicting the future of primary care in England

BMJ Online First
(1) Viral infection at birth linked to cerebral palsy

(Neurotropic viruses and cerebral palsy: population based case-control study)
http://bmj.bmjjournals.com/cgi/reprint/bmj.38668.616806.3A

Exposure to certain viral infections shortly before and after birth (the perinatal period) is associated with cerebral palsy, finds a study published online by the BMJ today.

These findings support the theory that infections during this period can trigger brain damage and the development of cerebral palsy.

The study took place at the Adelaide Women±s and Children±s Hospital in Australia and involved 443 children with cerebral palsy and 883 control babies. All babies were born to white mothers between 1986 and 1999.

Blood samples taken within a few days of birth were used to test for the presence of neurotropic viruses (a group of viruses including herpes viruses, which can all cross the placenta and infect the fetus).

Exposure to viral infection was common in all newborn babies, especially in preterm babies, implying that infection before birth may also be linked to preterm delivery.

Herpes group B viruses were found more often in babies who were later diagnosed with cerebral palsy than in control babies. In fact, the risk of cerebral palsy was nearly doubled with exposure to herpes group B viruses.

Despite some limitations, this study shows that perinatal exposure to neurotropic viruses is associated with preterm delivery and cerebral palsy, say the authors. Future studies are planned to investigate the possible causes of this link, they conclude.

Contact:
Catherine Gibson, Postdoctoral Research Fellow, Department of Obstetrics and Gynaecology, University of Adelaide, Women±s and Children±s Hospital, Adelaide, Australia Email: catherine.s.gibson@adelaide.edu.au

(2) Questions over ±healing effect± of magnets
(Editorial: Magnet therapy)
http://bmj.com/cgi/content/full/332/7532/4

Patients should be advised that magnet therapy has no proved benefits, and that any healing effect is likely to be small, say US researchers in this week±s BMJ.

Magnetic devices that are claimed to be therapeutic include magnetic bracelets, insoles, wrist and knee bands, back and neck braces, and even pillows and mattresses. Annual sales are estimated at more than a billion dollars globally.

But Professors Leonard Finegold and Bruce Flamm argue that many studies of magnet therapy are suspect because it is difficult to blind subjects to the presence of a magnet. They suggest that money spent on expensive and unproved magnet therapy might be better spent on evidence based medicine.

More importantly, self treatment with magnets may result in an underlying medical condition being left untreated, they warn.

Magnets are touted by successful athletes, allowed to be widely advertised, and sold without restrictions, so it is not surprising that lay people think that claims of therapeutic efficacy are reasonable, they write. However ± even theoretically ± magnet therapy seems unrealistic.

Extraordinary claims demand extraordinary evidence. Patients should be advised that magnet therapy has no proved benefits. If they insist on using a magnetic device they could be advised to buy the cheapest ± this will at least alleviate the pain in their wallet, the authors conclude.

Contacts:
Professor Leonard Finegold, Department of Physics, Drexel University, Philadelphia, PA, USA Tel (office): +1 215 895 2740 or (home): +1 610 566 4362 Email: l@drexel.edu

Professor Bruce Flamm, Kaiser Permanente Medical Center, Riverside, CA, USA Email: Bruceflamm@aol.com

(3) Predicting the future of primary care in England
(
Visions of primary care in 2015)
http://bmj.com/cgi/content/full/332/7532/41

What will English primary care look like in 2015?

The forthcoming white paper on health and community services in England will affect all of our futures, so the BMJ asked some people with an interest in general practice to predict the future.

General practices will be highly developed strategic organisations collaborating with each other in a community network, predict senior doctors at the Royal College of General Practitioners.

Their vision is for a strong and vibrant primary healthcare system that is patient centred, consistently of high quality, safe, and accountable. They urge policy makers is to build on the strengths and values of general practice, and avoid policies that run the risk of fragmenting care.

For Peter Lapsley, Chief Executive of the Skin Care Campaign, 2015 sees control of NHS budgets returned to central government and targets for access to general practitioners abandoned. Meanwhile, patients have embraced health promotion messages and regularly attend wellbeing centres, allowing doctors and nurses to spend more time with the sickest patients. The concept of ±patients as partners in their own healthcare± has also become a reality.

GP Dougal Jeffries predicts a return of a system based on social values. Expenditure on weapons has been diverted to the NHS, coordination and cooperation have superseded market forces, and patients are dealt with quickly and appropriately.

For Hamish Meldrum, Chairman of the BMA±s General Practitioners Committee, the future finds general practice under pressure.

Political interference has left the largely female profession feeling undervalued. The nature of general practice has also changed considerably, with larger practices offering a wider range of services and video phone consultations relieving some of the problems of access. The NHS is still, ostensibly, free at the point of use but patients have to pay for non-essential services including hotel charges in hospital.

By 2015, health care will be safe, clinically effective, and patient focused, concludes Carol Black, President of the Royal College of Physicians. She believes that patients will reject behaviours that harm health, but will continue to rely on their general practitioners to help them make decisions about health. Medical professionalism will ensure high levels of public trust.

Contacts:
Mayur Lakhani, Chairman, Royal College of General Practitioners, London, UK Tel (via Gillian Watson, PR Manager): Email: gwatson@rcgp.org.uk

Peter Lapsley, Chief Executive, Skin Care Campaign, London, UK Email: plapsley@eczema.org / peter.lapsley@btopenworld.com

Dougal Jeffries, General Practitioner, Health Centre, Isles of Scilly, UK Email: dougal.jeffries@ioshc.cornwall.nhs.uk

Hamish Meldrum, Chairman of the BMA General Practitioners Committee, London, UK (via Linda Millington, BMA Press Office): Email: lmillington@bma.org.uk

Carol Black, President, Royal College of Physicians, London, UK Tel (via Rachel Lea, RCP Press Office): Email: Rachel.Lea@rcplondon.ac.uk


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